if you have ever had metabolic acidosis (too much acid in your blood); or

if you have been on a ketogenic diet (high-fat, high-protein, low-carb).

You may have thoughts about suicide while taking this medicine. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

In animal studies, zonisamide caused birth defects and infant death. It is not known whether these effects would occur in people taking doses recommended for humans. Ask your doctor about your personal risk. Use effective birth control to prevent pregnancy while you are taking zonisamide.

If you are already pregnant, do not start or stop taking zonisamide during pregnancy without your doctor's advice. Zonisamide can cause metabolic acidosis, which could harm an unborn baby. However, having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant while taking zonisamide.

Zonisamide can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Zonisamide is not approved for use by anyone younger than 18 years old.

How should I take zonisamide?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take zonisamide with a full glass of water. Drink 6 to 8 glasses of water each day to prevent kidney stones while you are taking zonisamide.

Zonisamide can be taken with or without food.

Swallow the zonisamide capsule whole. Do not crush, chew, open, or break it.

While using zonisamide, you may need frequent blood tests.

If you need surgery, tell the surgeon ahead of time that you are using zonisamide. You may need to stop using the medicine for a short time.

Do not stop using zonisamide suddenly, even if you feel fine. Stopping suddenly may cause increased seizures. Follow your doctor's instructions about tapering your dose.

If you do stop taking zonisamide for any reason, talk with your doctor before restarting the medication. You may need to restart at a lower dose.

Seizures are often treated with a combination of drugs. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

Wear a medical alert tag or carry an ID card stating that you take zonisamide. Any medical care provider who treats you should know that you take seizure medication.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking zonisamide?

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how zonisamide will affect you.

Avoid drinking alcohol. It can increase some of the side effects of zonisamide.

What are the possible side effects of zonisamide?

Get emergency medical help if you have signs of an allergic reaction: any form of skin rash, hives; fever, swollen glands, feeling weak or tired, severe muscle pain, unusual bruising or bleeding; yellowing of your skin or the whites of your eyes; difficult breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: sudden mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), depressed, or have thoughts about suicide or hurting yourself.

severe skin reaction --fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

drowsiness, dizziness;

problems with memory or concentration;

feeling agitated or irritable;

loss of coordination, trouble walking; or

loss of appetite.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect zonisamide?

Taking this medicine with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking zonisamide with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety or depression.

Other drugs may interact with zonisamide, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

Your pharmacist can provide more information about zonisamide.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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